经减肥地中海饮食/生活方式干预后，阻塞性睡眠呼吸暂停患者的心血代谢特征持续改善：“MIMOSA”随机临床试验的 12 个月随访（干预后 6 个月）。

Sustained improvements in the cardiometabolic profile of patients with obstructive sleep apnea after a weight-loss Mediterranean diet/lifestyle intervention: 12-month follow-up (6 months post-intervention) of the "MIMOSA" randomized clinical trial.

机构信息

Department of Nutrition & Dietetics, School of Health Sciences & Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17676 Athens, Greece.

Center of Sleep Disorders, 1st Department of Critical Care and Pulmonary Services, Evangelismos Hospital, 45-47 Ipsilantou Str., 10676 Athens, Greece.

出版信息

Nutr Metab Cardiovasc Dis. 2023 May;33(5):1019-1028. doi: 10.1016/j.numecd.2023.02.010. Epub 2023 Feb 18.

DOI:10.1016/j.numecd.2023.02.010

PMID:36958969

Abstract

BACKGROUND AND AIMS

Obstructive sleep apnea (OSA) and the metabolic syndrome (MS) frequently coexist and lead to increased cardiometabolic morbidity. We aimed to explore the long-term cardiometabolic benefits of a weight-loss Mediterranean diet/lifestyle intervention in OSA.

METHODS AND RESULTS

As many as 180 adults with overweight/obesity and polysomnography-diagnosed moderate-to-severe OSA were randomized to a standard care (SCG, n = 62), a Mediterranean diet (MDG, n = 59) or a Mediterranean lifestyle group (MLG, n = 59). All groups were prescribed with continuous positive airway pressure (CPAP), while intervention arms (MDG/MLG) additionally participated in a 6-month weight-loss intervention based on the Mediterranean diet/lifestyle. Cardiometabolic parameters were evaluated at baseline and 12 months (6 months post-intervention). Data were analyzed using the intention-to-treat method, and 12-month between-group differences were explored while adjusting for age, sex, baseline status and CPAP use. Compared to the SCG, intervention arms exhibited lower insulin, triglycerides and high-sensitivity C-reactive protein, and higher high-density lipoprotein cholesterol; the MDG also exhibited lower diastolic blood pressure, while the MLG exhibited lower glucose and systolic blood pressure (all P < 0.050). The relative risk (95% confidence interval) of MS was 0.60 (0.36, 0.99) in the MDG versus the SCG, 0.33 (0.20, 0.55) in the MLG versus the SCG and 0.55 (0.32, 0.93) in the MLG versus the MDG. The risk of MS remained lower in the MLG versus the other study groups (both P < 0.050) after additional adjustment for body weight change.

CONCLUSION

Cardiometabolic benefits of a 6-month healthy dietary/lifestyle intervention are sustainable 6 months post-intervention in OSA.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02515357, August 4, 2015.

摘要

背景与目的

阻塞性睡眠呼吸暂停（OSA）和代谢综合征（MS）常同时存在，导致心血管代谢疾病发病率增加。我们旨在探讨减肥地中海饮食/生活方式干预对 OSA 的长期心血管代谢益处。

方法和结果

共有 180 名超重/肥胖且经多导睡眠图诊断为中重度 OSA 的成年人被随机分为标准治疗组（SCG，n=62）、地中海饮食组（MDG，n=59）或地中海生活方式组（MLG，n=59）。所有组均被处方持续气道正压通气（CPAP），而干预组（MDG/MLG）还额外参加了为期 6 个月的基于地中海饮食/生活方式的减肥干预。在基线和 12 个月（干预后 6 个月）评估心血管代谢参数。采用意向治疗法分析数据，并在调整年龄、性别、基线状态和 CPAP 使用的情况下，探讨了 12 个月时组间差异。与 SCG 相比，干预组的胰岛素、甘油三酯和高敏 C 反应蛋白水平较低，高密度脂蛋白胆固醇水平较高；MDG 组的舒张压也较低，而 MLG 组的血糖和收缩压较低（均 P<0.050）。MDG 组与 SCG 相比，MS 的相对风险（95%置信区间）为 0.60（0.36，0.99），MLG 组与 SCG 相比为 0.33（0.20，0.55），MLG 组与 MDG 组相比为 0.55（0.32，0.93）。在进一步调整体重变化后，MLG 组与其他研究组相比，MS 的风险仍然较低（均 P<0.050）。